When prescribed both Albuterol (Proventil) and beclomethasone dipropionate (QVAR) inhalers for asthma, when, how and why should the patient use these in a special sequence?

Use the albuterol inhaler 5 min before using the beclomethasone inhaler because the beta-2 agonist (Albuterol) promotes bronchodillation and enhances the absorption of the glucocorticoid (beclamethasone).

Albuterol is used for asthma treatment to?

promote bronchodilation

Glucocorticoids and cromolyn decrease?

inflammation

Montelukast (Singular) a leukotriene modifier decrease _______ _______ production and supress the effects of ________ _________.

airway mucus, leukotriene compounds

Glucocorticoids can result in weight _____ and fluid ______.

gain, retention

Subcutaneous needles are between ___ and ___ in. long.

1/4 to 5/8 in. long

Sites for subq injections are:
1-
2-
3-
4-
5-

1-upper arm

2-upper back

3-abdomen

4-thighs

5-top of buttocks

A nurse is preparing to give an obese patient a subq injection. She knows which angle is best?

90

The two angles for giving subcutaneous injections are?

45 and 90

Subcutaneous syringes are no more than __mL.

1mL

IM deltoid needles are __in. long?

1inch

IM Deltoid syringes are up to __mL?

3mL

Where are four IM injection sites?

1-Deltoid

2-Ventrogluteal

3-Dorsogluteal

4-Vastus Lateralis

Mucolytics work on the ______.

cilia

Surfactants work in the _______?

alveoli

Antitussives ______ the cough reflex.

supress

The antitussive Benzonatate (Tessalon) acts like a _________ _________ for a _________ cough.

numbing agent, non-productive.

Dextromethorphan (Benylin) belongs to which class of drugs?

Antitussives

Sally is walking through the perfume department at her favorite departments store as another customer sprays several perfumes. The correct antitussive for this kind of non-productive cough due to irritation of the throat would be? And why?

Benzonotate (Tessalon) because it's a numbing agent.

If a patient has a severe, non-productive cough that just won't go away and is causing irritation, the nurse would administer which antitussive and why?

Either Dextromethorphan (Benylin) or Hydrocodone (Hycodan) because they supress the cough reflex in the brain.

Adverse reactions associated with antitussives are (3):

Dizziness (CNS), respiratory depression, dry mouth.

Decongestants cause vasoconstriction or vasodilation of upper airway?

vasoconstriction (to allow drainage)

Topical decongestants are _____________, meaning that they imitate the effects of the sympathetic nervous system.

sympathomimetics

Oxymetazoline (Afrin) and Ephedrine (Pretz-D) are examples of what class of respiratory drugs?

Decongestants

_______ decongestants are not absorbed into the blood stream.

Topical

Describe the rebound effect:

After taking Afrin for several weeks you suddenly stop and the symptoms are worse than before. You have built up a tolerance for the drug and need more each time for it to work.

Steroids should be avoided for patients that have vasoconstriction. Give some examples:

Glaucoma, CV, thyroid, HTN

Is the decongestant Ephedrine (Pretz-D) topical or oral?

topical

Is the decongestant pseudoephedrine (Sudafed) topical or oral?

Oral

Beclomethasone (Beclovent) and flunisolide (Aerobid) are examples of what class of respiratory drugs?

Topical steroid nasal decongestants (reduce inflammation)

Topical steroids can cause an overgrowth of ______________.

candida

Diphenhydramine (Benadryl) and Promethazine (Phenergen) belong to which class of respiratory drugs?

Antihistamines

True or False:

The nurse knows Benadryl can be used to treat, prophylactically or for it's sedation qualities.

True

Promethazine (Phenergen) is used as (2 things)?

antihistamine or nausea

Antihistamines can cause a __________ _________.

fatal interval.

This classification can cause ______ ______ with prolonged QT interval.

fatal arrythmeas

A very serious drug interaction for antihistamines is?

MSO inhibitors (anti-depressant)

It's very important to assess the _____ and the ___ when administering an antihistamine.

heart, GI

A glaucoma patient complains of irritation to their eyes after taking a Sudafed for 3 days. What is this patient at risk for? and why shouldn't they be taking this?

blindness, b/c decongestants are vasodilators.

Guaifenesin (Mucinex) is?

an expectorant

Acetylcysteine (Mucomyst) is?

Mucolytic

Because mucolytics and expectorants liquify secretions, it is always important to teach the patient to?

drink fluids

What is the antidote for acetaminophen poisoning?

Acetylcysteine (Mucomyst)

Be aware of _______ when administering mucomyst via nebulizer.

skin excoriation

Antitussives and decongestants affect which part of the respiratory tract, upper or lower?

upper

ARDS & RDS stand for?

Acute respiratory distress syndrome and Respiratory distress syndrome

RDS refers to?

any obstructrions at the alveoli

The progressive loss of lung compliance and hypoxia refers to?

ARDS

The nurse has control over RDS or ASRDS?

ARDS

ARDS can happen within __ hours.

24

RDS or ARDS is completely preventable?

ARDS

Xanthines, enzyme therapy, sympathomimetics and anticholinergenics are all examples of?

Bronchodilators/Antiasthmatics

Caffeine, aminophylline and theophylline are all examples of what group of bronchodilators?

Xanthines

Common side effects of xanthines are:

tachycardia, jitters

The nurse is concerned because her smokes and is taking a __________.

xanthine

Alpha1-protease inhibitor treats a __________ deficiency?

protease

An emphysematic patient in their 30's or 40's is most likely to be prescribed this therapy.

Alpha1-protease inhibitor (enzyme therapy)

Alpha1-protease inhibitor is specifically for treatment of ________ deficiency.

protease

Smokers who have the protease deficiency are at risk for severe _____ destruction.